How much rates vary
Facilitymedian $251 · 10th to 90th $135 to $437Professionalmedian $513 · 10th to 90th $257 to $676
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $229.09 Median $257.04 Typical High $257.04 | Facility | None | $229.09 | $257.04 | $257.04 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $169.82 Median $177.83 Typical High $194.98 | Facility | 54 · Surgery only | $169.82 | $177.83 | $194.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $22.91 Median $23.99 Typical High $25.70 | Facility | 56 · Pre-op care only | $22.91 | $23.99 | $25.70 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $165.96 Typical High $181.97 | Facility | 78 · Unplanned return to OR | $158.49 | $165.96 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $239.88 Typical High $323.59 | Professional | None | $223.87 | $239.88 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $177.83 Typical High $204.17 | Professional | 54 · Surgery only | $169.82 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $23.99 Typical High $27.54 | Professional | 56 · Pre-op care only | $22.91 | $23.99 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $165.96 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $158.49 | $165.96 | $190.55 |
BCBS North Dakota Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $676.08 | Professional | None | $436.52 | $549.54 | $676.08 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $524.81 Median $660.69 Typical High $812.83 | Professional | 22 · Increased work | $524.81 | $660.69 | $812.83 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $380.19 Typical High $467.74 | Professional | 54 · Surgery only | $309.03 | $380.19 | $467.74 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $54.95 Typical High $67.61 | Professional | 56 · Pre-op care only | $43.65 | $54.95 | $67.61 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $407.38 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $331.13 | $407.38 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $537.03 | Facility | None | $467.74 | $467.74 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $512.86 Typical High $741.31 | Professional | None | $269.15 | $512.86 | $741.31 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $257.04 Typical High $436.52 | Facility | None | $125.89 | $257.04 | $436.52 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $478.63 Typical High $1,737.80 | Professional | None | $263.03 | $478.63 | $1,737.80 |
United Setting Facility Modifier None Typical Low $125.89 Median $251.19 Typical High $269.15 | Facility | None | $125.89 | $251.19 | $269.15 |
United Setting Professional Modifier None Typical Low $234.42 Median $436.52 Typical High $512.86 | Professional | None | $234.42 | $436.52 | $512.86 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $114.82 Median $120.23 Typical High $128.82 | Facility | 52 · Reduced service | $114.82 | $120.23 | $128.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $45.71 Median $47.86 Typical High $51.29 | Facility | 53 · Discontinued | $45.71 | $47.86 | $51.29 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $33.88 Median $35.48 Typical High $38.90 | Facility | 55 · Aftercare only | $33.88 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $120.23 Typical High $138.04 | Professional | 52 · Reduced service | $114.82 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $47.86 Typical High $54.95 | Professional | 53 · Discontinued | $45.71 | $47.86 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $35.48 Typical High $40.74 | Professional | 55 · Aftercare only | $33.88 | $35.48 | $40.74 |
Where North Dakota sits
The same service costs 5.1 times more in Alaska than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
North Dakota· 7th of 51
$490
AK $955UT $186
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.